scholarly journals Inclusive HIV Prevention in South Africa: Reaching Foreign Migrant Adolescent Girls

2021 ◽  
Vol 3 ◽  
Author(s):  
Miriam Temin ◽  
Cecilia Milford ◽  
Mags Beksinska ◽  
Debbie Van Zyl ◽  
Jonathan Cockburn
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Adolescent Girls ◽  
Hiv Risk ◽  
Financial Literacy ◽  
Teenage Pregnancy ◽  
Sexual Debut ◽  
Group Discussions ◽  
Related Factors ◽  
Related Stigma

Within South Africa's HIV epidemic, foreign migrant adolescent girls and young women (AGYW) face unique challenges in an environment typified by xenophobia and structural inequity. The intersection of age, gender, and migrant-related factors creates threats that may exacerbate their HIV risk, including discrimination, limited social capital, and economic dependency. This paper explores HIV-related determinants of risk from the perspective of foreign migrant AGYW who participated in a Girls' Club project implemented by Community Media Trust. Within clubs, foreign migrant AGYW met weekly with a female mentor to discuss HIV, safety planning, financial literacy, and other topics. Focus group discussions (FGDs) were conducted with club members and parents to learn about pressing challenges in a context characterized by early sexual debut, high rates of teenage pregnancy, and relationships typified by material exchange. FGDs addressed HIV risk factors such as social isolation and limited access to services, exacerbated by migrant-related stigma and discrimination and lack of identity documents. The foreign migrant AGYW appreciated the role of the Girls' Clubs and mentors in helping them overcome barriers to school and health services as well as building their social and other assets. FGD results indicate that HIV prevention in South Africa should prioritize action to address the specific determinants of foreign migrant AGYW's HIV risk, as well as inclusive policies that recognize migrants' heterogeneity based on gender and age.

scholarly journals Exploring the feasibility and acceptability of integrating screening for gender-based violence into HIV counselling and testing for adolescent girls and young women in Tanzania and South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuela Colombini ◽  
◽  
Fiona Scorgie ◽  
Anne Stangl ◽  
Sheila Harvey ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Young Women ◽  
Hiv Risk ◽  
Clinical Staff ◽  
Gender Based Violence ◽  
Process Data ◽  
Hiv Counselling And Testing ◽  
Gender Based ◽  
Study Participants

Abstract Background Gender-based violence (GBV) undermines HIV prevention and treatment cascades, particularly among women who report partner violence. Screening for violence during HIV testing, and prior to offering pre-exposure prophylaxis (PrEP) to HIV uninfected women, provides an opportunity to identify those at heightened HIV risk and greater potential for non-adherence or early discontinuation of PrEP. The paper describes our experience with offering integrated GBV screening and referral as part of HIV counselling and testing. This component was implemented within EMPOWER, a demonstration project offering combination HIV prevention, including daily oral PrEP, to young women in South Africa and Tanzania. Methods Between February 2017 and March 2018, a process evaluation was conducted to explore views, experiences and practices of stakeholders (study participants and study clinical staff) during implementation of the GBV screening component. This article assesses the feasibility and acceptability of the approach from multiple stakeholder perspectives, drawing on counselling session observations (n = 10), in-depth interviews with participants aged 16–24 (n = 39) and clinical staff (n = 13), and notes from debriefings with counsellors. Study process data were also collected (e.g. number of women screened and referred). Following a thematic inductive approach, qualitative data were analysed using qualitative software (NVivo 11). Results Findings show that 31% of young women screened positive for GBV and only 10% requested referrals. Overall, study participants accessing PrEP were amenable to being asked about violence during HIV risk assessment, as this offered the opportunity to find emotional relief and seek help, although a few found this traumatic. In both sites, the sensitive and empathetic approach of the staff helped mitigate distress of GBV disclosure. In general, the delivery of GBV screening in HCT proved to be feasible, provided that the basic principles of confidentiality, staff empathy, and absence of judgment were observed. However, uptake of linkage to further care remained low in both sites. Conclusion Most stakeholders found GBV screening acceptable and feasible. Key principles that should be in place for young women to be asked safely about GBV during HIV counselling and testing included respect for confidentiality, a youth-friendly and non-judgmental environment, and a functioning referral network.

scholarly journals Perceived Facilitators and Barriers to Participating in a Combination Income-Generating HIV Risk-Reduction Intervention Among Adolescent Girls and Young Women in Nigeria: A Qualitative Study

2021 ◽  
Vol 3 ◽  
Author(s):  
Ucheoma Nwaozuru ◽  
Wakilat Tijani ◽  
Titi Gbajabiamila ◽  
Chisom Obiezu-Umeh ◽  
Florida Uzoaru ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Risk Reduction ◽  
Adolescent Girls ◽  
Hiv Risk ◽  
Hiv Risk Reduction ◽  
Hiv Prevention Intervention ◽  
School Based ◽  
Facilitators And Barriers ◽  
Risk Reduction Intervention ◽  
Study Participants

Background: Human immunodeficiency virus risk-reduction interventions that include income-generating activities are garnering attention as effective strategies to engage adolescent girls and young women (AGYW) toward HIV risk reduction. To sustain and promote the uptake of these interventions, researchers must understand factors that may encourage or present barriers to AGYW participation in such interventions. This study explores AGYW perceived barriers and facilitators to participation in a school-based combination income-generating HIV prevention intervention in Nigeria.Methods: A convenience sample of AGYW who participated in a school-based combination income-generating HIV prevention intervention were recruited for the study. Data generated from focus group discussions (FGDs) (eight discussion groups comprising 10–12 participants) were analyzed by inductive thematic analysis.Results: A total of 93 participants with a mean age of 15.04 years (SD = 0.89) participated in the FGDs. The study participants identified several facilitators and barriers to participation in the intervention. Three main themes that emerged as facilitators were: (1) involvement of young female facilitators in the delivery of intervention components, (2) opportunity for social interaction with peers during the intervention period, and (3) support and approval from school authorities. Two main themes were also identified as barriers: (1) sexual conservatism from society and parents and (2) challenges in sustaining a microenterprise.Conclusions: Despite the perceived benefits and interest in participation in the intervention, the study participants outlined some challenges that may hinder participation in the intervention components. Addressing barriers, such as stigma associated with the discussion of sexual health-related topics, coupled with the promotion of facilitating factors, such as leveraging context-appropriate intervention delivery modalities, is important for enhancing the engagement of AGYW in HIV risk-reduction intervention. Our findings can guide future research and design of combination income-generating HIV prevention interventions for in-school AGYW in low-resource settings such as Nigeria.

scholarly journals Predictors of contraceptive use among adolescent girls and young women (AGYW) aged 15 to 24 years in South Africa: results from the 2012 national population-based household survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
L. Makola ◽  
L. Mlangeni ◽  
M. Mabaso ◽  
B. Chibi ◽  
Z. Sokhela ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Young Women ◽  
Contraceptive Use ◽  
Sexual Debut ◽  
Health Planning ◽  
Household Survey ◽  
Population Based ◽  
Stepwise Logistic Regression ◽  
Unintended Pregnancies

Abstract Background Despite a variety of contraceptives being available for women in South Africa, a considerable number of adolescent girls and young women still face challenges in using them. This paper examines socio-demographic and behavioral predictors of using contraceptives among adolescent girls and young women (AGYW) aged 15 to 24 years. Methods A secondary data analysis was conducted based on the 2012 population-based nationally representative multi-stage stratified cluster randomised household survey. Multivariate backward stepwise logistic regression model was used to examine socio-demographic and behavioural factors independently associated with contraceptive use amongst AGYW aged 15 to 24 years in South Africa. Results Out of 1460 AGYW, 78% (CI: 73.9–81.7) reported using some form of contraceptives. In the model, contraceptive use was significantly associated with secondary education [OR = 1.8 (1.2–2.7), p = 0.005], having a sexual partner within 5 years of their age [OR = 1.8 (1.2–2.5), p = 0.002], and sexual debut at age 15 years and older [OR = 2.5 (1.3–4.6), p = 0.006]. The likelihood of association decreased with other race groups-White, Coloured, and Indians/Asians [OR = 0.5 (0.3–0.7), p = 0.001], being married [OR = 0.4 (0.2–0.7), p = 0.001], never given birth [OR = 0.7 (0.5–0.9), p = 0.045], coming from rural informal [OR = 0.5 (0.3–0.9), p = 0.010] and rural formal settlements [OR = 0.5 (0.3–0.9), p = 0.020]. Conclusions Evidence suggest that interventions should be tailor-made to meet the needs of AGYW in order to, promote use and access to contraceptives. The results also suggest that family planning interventions should target those who had not given birth in order to reduce unplanned and or unintended pregnancies and associated risk factors. These findings contribute to public health discourse and reproductive health planning for these age groups in the country.

Consumer Journeys of Adolescent Girls and Young Women in South Africa: Implications for Marketing HIV Prevention Products

2021 ◽  
pp. 152450042110309
Author(s):  
Michelle Dugas ◽  
Kenyon Crowley ◽  
Guodong (Gordon) Gao ◽  
Lorcan McHarry ◽  
Louise Kenmuir ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
South African ◽  
Health Beliefs ◽  
Adolescent Girls ◽  
Young Women ◽  
Low Income ◽  
Sexual Experience ◽  
Personal Hygiene ◽  
Consumer Journeys

Background: Female-initiated prevention products could reduce HIV infection rates in contexts with pronounced gender inequality like South Africa, but uptake and adherence remain low when available. Insights into the behavior of target consumers are needed to effectively promote these products; however, perceptions of stigma may discourage honest reporting. Focus of the Article: To address this need, we examined differences among the consumer journeys of six segments of South African adolescent girls and young women (AGYW), who vary on sexual health beliefs, sexual experience, and self-enhancement, when buying hygiene products. Research Question: We hypothesized that segments would differ in what motivated their purchases and in engagement with different touchpoints, reflecting a need for targeted outreach strategies. Methods: 1,500 low-income, Black South African AGYW (14–25 years of age) were surveyed face-to-face in their homes about their consumer journeys when purchasing deodorant and sanitary products, with the aim of extending the insights obtained to HIV prevention. Results: We found notable similarities across segments but also several important differences underscoring the potential for tailored marketing of HIV prevention products. Among some of the segments, differences were found in prepurchase mindsets and touchpoints, retail and brand drivers, and postpurchase feelings. Recommendations for Research or Practice: These findings highlight the need for tailored outreach among AGYW and may inform the design of effective, personalized marketing strategies that enhance the appeal of HIV prevention products. Limitations: To circumvent potential stigma associated with HIV, survey questions were anchored on personal hygiene products. While this may encourage greater honesty, findings may not fully generalize to HIV prevention products.

scholarly journals Association between sexual violence and unintended pregnancy among adolescent girls and young women in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anthony Idowu Ajayi ◽  
Henrietta Chinelo Ezegbe
Keyword(s):  
South Africa ◽  
Sexual Violence ◽  
Unintended Pregnancy ◽  
Adolescent Girls ◽  
Young Women ◽  
Teenage Pregnancy ◽  
Multivariable Analysis ◽  
Limited Attention ◽  
Cross Sectional ◽  
Unintended Pregnancies

Abstract Background Unintended pregnancy has dire consequences on the health and socioeconomic wellbeing of adolescent girls and young women (AGYW) (aged 15–24 years). While most studies tend to focus on lack of access to contraceptive information and services, and poverty as the main contributing factor to early-unintended pregnancies, the influence of sexual violence has received limited attention. Understanding the link between sexual violence and unintended pregnancy is critical towards developing a multifaceted intervention to reduce unintended pregnancies among AGYW in South Africa, a country with high teenage pregnancy rate. Thus, we estimated the magnitude of unintended pregnancy among AGYW and also examined the effect of sexual violence on unintended pregnancy. Methods Our study adopted a cross-sectional design, and data were obtained from AGYW in a South African university between June and November 2018. A final sample of 451 girls aged 17–24 years, selected using stratified sampling, were included in the analysis. We used adjusted and unadjusted logistic regression analysis to examine the effect of sexual violence on unintended pregnancy. Results The analysis shows that 41.9% of all respondents had experienced an unintended pregnancy, and 26.3% of those unintended pregnancies ended in abortions. Unintended pregnancy was higher among survivors of sexual violence (54.4%) compared to those who never experienced sexual abuse (34.3%). In the multivariable analysis, sexual violence was consistently and robustly associated with increased odds of having an unintended pregnancy (AOR:1.70; 95% CI: 1.08–2.68). Conclusion Our study found a huge magnitude of unintended pregnancy among AGYW. Sexual violence is an important predictor of unintended pregnancy in this age cohort. Thus, addressing unintended pregnancies among AGYW in South Africa requires interventions that not only increase access to contraceptive information and services but also reduce sexual violence and cater for survivors.

scholarly journals Adolescent girls and young women’s PrEP-user journey during an implementation science study in South Africa and Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258542
Author(s):  
Elzette Rousseau ◽  
Ariana W. K. Katz ◽  
Shannon O’Rourke ◽  
Linda-Gail Bekker ◽  
Sinead Delany-Moretlwe ◽  
...  
Keyword(s):  
South Africa ◽  
Adolescent Girls ◽  
Scale Up ◽  
Structural Factors ◽  
Focus Group Discussions ◽  
Science Study ◽  
Group Discussions ◽  
Health Counseling ◽  
Sexual Reproductive Health ◽  
Early Use

Successful scale-up of PrEP for HIV prevention in African adolescent girls and young women (AGYW) requires integration of PrEP into young women’s everyday lives. We conducted interviews and focus group discussions with 137 AGYW PrEP users aged 16–25 from South Africa and Kenya. Individual and relational enablers and disablers were explored at key moments during their PrEP-user journey from awareness, initiation and early use through persistence, including PrEP pauses, restarts, and discontinuation. PrEP uptake was facilitated when offered as part of an integrated sexual reproductive health service, but hampered by low awareness, stigma and misconceptions about PrEP in the community. Daily pill-taking was challenging for AGYW due to individual, relational and structural factors and PrEP interruptions (intended or unintended) were described as part of AGYW’s PrEP-user journey. Disclosure, social support, adolescent-friendly health counseling, and convenient access to PrEP were reported as key enablers for PrEP persistence.

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